BLADDER RUPTURE

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Vesna Ivancic Gillian Lieberman, MD IPBR vs EPBR INTRAPERITONEAL EXTRAPERITONEAL PROPORTION 10-20% 80-90% MOST HAVE PELVIC FX CAUSATIVE Blunt (seat belt) Shearing FORCES To Lower abdomen To bladder base Full Bladder Or Injury via bone fragments URINE = NONCOMPRESSIBLE FLUID! DISTENDED <strong>BLADDER</strong> = THIN WALL! EXTENSION Ruptures at dome Extends into peritoneal cavity MANAGEMENT Surgical Conservative Extends into prevesical soft tissues, perineum, scrotum, thigh, anterior abdominal wall, retrorectal/presacral sp. 16
Vesna Ivancic Gillian Lieberman, MD IPBR PATTERN ON CYSTOGRAPHY GENERAL FEATURES • Smooth, regular contours • Contrast accumulates near dome and extends laterally filling peritoneal cavity • Surrounds bowel, forming gas-filled defects surrounded by circular segments of contrast • Scalloped effect near paracolic recesses, haustra • May outline liver margin Ney and Fiedenberg, 1981 17
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BLADDER RUPTURE

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